ORS - TORT Agent

Key responsibilities and day to day responsibilities of this position: A Tort Agent uses automated computer systems and associated business practices to verify, investigate, and/or collect from potential third-party payers for the Medicaid program. They provide customer assistance, process legal documents, compile and compose claims/liens or other correspondence, verify potential third-party payers, and any other information affecting collection and/or compliance potential. An agent will explain to customers their responsibilities for payment on a Medicaid lien by telephone, correspondence, or in person. They will receive payments on accounts, evaluate accounts to verify claims or liens have been filed, review cases for appropriate payment and potential third-party payers, and/or determine appropriate legal action and next steps. They may research, calculate amounts due, and/or prepare documentation for further action. They will gather relevant information through interviews or record searches, analyzing facts, and applying knowledge of agency rules, regulations, and policies, etc. They may also: Negotiate settlement of claims Work with recipients, attorneys, and insurance companies to pursue debts owed to the State of Utah Provides customer service for clients/customers in various state agencies and private companies Maintain proficient computer skills in various state systems and online resources Reviews Medicaid paid claims information maintained in state computer systems and using knowledge of state and federal statute and insurance coverage and practices; files appropriate claims to reimburse the Medicaid program Maintain accurate computer system accounting records for medical debts to ensure that receipts are posted in accordance with established state business practices.